EHR? Not so fast - Patients express security concerns

CDW Healthcare, part of the public sector subsidiary of CDW LLC, today announced the results of a national survey on patient perceptions of electronic health records (EHRs) and the security of personal health information (PHI).  The report, “Elevated Heart Rates:  EHR and IT Security,” found that while patients trust their doctors to protect their information, 49 percent believe that EHRs will have a negative impact on the privacy of their PHI and health data.

As healthcare organizations transition to EHRs, they will be responsible for maintaining and protecting a significant amount of personal data electronically.  According to the survey, patients not only require that PHI be held securely, but also believe that healthcare organizations are responsible for protecting financial information (86 percent), personally identifiable information (93 percent) and any information provided about a patient’s family (94 percent).

“The new era of EHR brings with it a whole new set of requirements for healthcare organizations – particularly in the area of IT security,” said Bob Rossi, vice president of CDW Healthcare.  “Digital files are not inherently less secure than paper files, but they do require a completely different set of technologies, processes and internal policies for protection.”

In fact, recent research from CDW Healthcare indicates that many physician practices have not yet prioritized IT security.  According to CDW Healthcare’s Physician Practice EHR Price Tag, 30 percent of physician practices report that they lack basic anti-virus software and 34 percent report that they do not use network firewalls.  Both elements are considered basic steps in developing a minimum IT security profile.

According to the U.S. Department of Health and Human Services, patients should expect significant benefits from the PHI included in EHRs, including:

• The reduction of adverse drug events, medical errors and redundant tests and procedures when used in conjunction with e-prescribing;
• The regular use of preventive services such as health screenings, which can help reduce health care costs;
• Improved communication between patients and providers, giving patients better access to timely information; and
• The reduction of office waiting time by improving office efficiency.[1]

Both the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the Health Information Technology for Economic and Clinical Health (HITECH) Act set standards for protecting PHI and create penalties for any violations.  Beyond those formal penalties, however, patients may respond to any breach of trust with a changed business relationship.  For survey respondents who were notified of a breach of their personal data from any business or organization in the past, 33 percent changed their relationship with the offending organization, including 9 percent that severed the relationship, 12 percent that reduced spending and 12 percent that no longer trust that organization.

Ultimately, survey respondents put responsibility for the protection of their information directly on physician practices.  When asked who they hold primarily responsible for the privacy and security of their health information, 84 percent of respondents cited either a staff member at the doctors’ office by role, or the medical practice as a whole.

“For physician practices, IT security must be a primary part of any EHR,” said Rossi.  “Right now, patients trust their doctors more than anyone else to protect their personal information.  But like any relationship based upon trust, even one breach can fundamentally change the dynamic.”

Based upon extensive work in both healthcare IT and information security, CDW Healthcare has identified preliminary steps for healthcare organizations focused on improving their security profile:

• Execute an IT Security Assessment:  Many healthcare organizations do not know the current state of their IT security infrastructure.  Fewer still know what constitutes an adequate profile.  Healthcare organizations need to work with a trusted partner to secure a baseline understanding of what their security profile looks like today
• Start with the Basics:  Notably, 30 percent of physician practices state that they do not use antivirus software and 34 percent do not use network firewalls.  At the absolute minimum, healthcare organizations need to immediately implement steps to meet reasonable security standards
• Protect Your Investment:  As healthcare organizations consider the transition to EHRs, they have the perfect opportunity to implement IT security practices tailored to their solution.  This not only protects a sizable investment in technology, but also ensures that as patient data goes digital, security protections are already in place
• Start Now; Reassess Often:  IT security is not a one-time fix.  Though the EHR transition is a perfect time to initiate tighter IT security controls, all healthcare organizations need to consider their IT security profiles and should consider conducting an assessment at least once a year

CDW Healthcare conducted a survey of 1,000 respondents across the United States from January 24 to January 31.  The age and gender distribution of the survey sample match that of the overall U.S. population.  All survey respondents had been to both a doctors’ office and hospital/outpatient clinic in the previous 18 months.

A full copy of CDW Healthcare’s Elevated Heart Rates:  EHR and IT Security Report is available at http://www.cdw.com/HeartRates.  Additional information on CDW Healthcare and its EHR solutions is available at www.CDW.com/CommunIT. 

[1] Department of Health and Human Services (2008).  HHS Announces Project to Help 3.6 Million Consumers Reap Benefits of Electronic Health Records.  [Press Release]  Retrieved from http://www.hhs.gov/news/press/2007pres/10/pr20071030a.html